This study proposes to extend knowledge regarding the individual and the family during recovery from the situational crisis of open-heart surgery, specifically, coronary artery bypass grafting and valve replacement. The study will employ nursing interventions during the hospitalization period, and for three months thereafter, which are designed to improve individual and family health during recovery. The effectiveness of these interventions will be assessed through a randomized controlled trial in which 200 prospective bypass and valve surgery patients, ages 40-75, and their spouses will be randomly allocated to receive the experimental interventions or usual care. Specific study aims are: 1. to test the efficacy of nursing interventions designed to facilitate posthospital recovery and rehabilitation of the cardiac patient and his family unit; 2. to determine the impact of the valve and bypass surgery on the marital adjustment of the couple and the health of the family unit; 3. to describe differences in recovery from coronary bypass surgery and valve replacement during the early postoperative period (2-26 weeks). Long term objectives are to maximize family and personal resources in recovery from surgical treatment for heart disease, in ways that are therapeutic and cost effective for patients and their families.